| NPI | 1316199821 |
|---|---|
| Former Name | ANDREA DECOSTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 7839) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 800) |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2023-12-25 |